Provider Demographics
NPI:1083884449
Name:ASSADINIA, JAMSHID K (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMSHID
Middle Name:K
Last Name:ASSADINIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:K
Other - Last Name:ASSADINIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:300 S ALLEN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4841
Mailing Address - Country:US
Mailing Address - Phone:814-237-3006
Mailing Address - Fax:814-237-0040
Practice Address - Street 1:300 S ALLEN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4841
Practice Address - Country:US
Practice Address - Phone:814-237-3006
Practice Address - Fax:814-237-0040
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025973L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist